Background: More than half of HIV infected individuals in Kenya are unaware of their status
and young women carry a disproportionate burden of incident HIV infections. We sought to
increase HIV testing in young Kenyan women through a text messaging (SMS) intervention.
Methods: We conducted a randomized quasi-experimental study to increase HIV testing among
women 18-24 years old. Four technical training colleges in Central Kenya were randomized to
have their study participants receive either weekly SMS on HIV and reproductive health topics
or no SMS. Monthly 9-question SMS surveys were sent to all participants for 6 months to
collect data on HIV testing, sexual behavior, and HIV risk perception. We used multivariate Cox
proportional hazards regression to detect differences in the time to the first HIV test reported by
women during the study period.
Results: We enrolled 600 women between September 2013 and March 2014 of whom 300
received weekly SMS and monthly surveys and 300 received only monthly surveys. On average,
women were 21 years of age (interquartile range [IQR] 20-22), 68% had ever had sex and 73%
had never tested for HIV. A total of 356 women reported testing for HIV within the 6 months of
follow up: 67% from the intervention arm and 51% from the control arm (hazard ratio=1.57,
95% confidence interval 1.28-1.92).
Conclusions: Use of weekly text messages about HIV prevention and reproductive health
significantly increased rates of HIV testing among young Kenyan women and would be feasible
to implement widely among school populations.